Abstract P645: Lower Satisfaction With Healthcare Providers’ Communication Associated With African Americans Seeking Care From Complementary and Alternative Medicine Providers: The Jackson Heart Study
Authors: Saara Z Nasruddin, Benjamin Walker, Elizabeth Heitman, Nelson Atehortua, Jennifer Reneker
Journal: Circulation (2023)

Introduction: Individuals who use complementary and alternative medicine (CAM) have been found to have a greater sense of agency and control over their health, a goal that mainstream healthcare providers are also encouraged to promote through patient- centered communication. Patient-centered communication helps patients to feel heard, understood, and involved in their health decisions. The relationship between patient-centered communication and the use of CAM by African Americans has not been previously described. Hypothesis: African Americans who report less satisfaction with their healthcare providers’ communication will be more likely to seek CAM providers. Methods: This was a secondary analysis of data from the Jackson Heart Study, a longitudinal cohort study of African Americans in the Jackson, Mississippi metropolitan area. We performed a cross-sectional analysis of annual follow up data collected between 2004 and 2006. The exposure variables included participants’ satisfaction with their healthcare providers’ communication, which was captured by four items, which asked: “How often did your doctor or other healthcare providers listen carefully to you/explain things in a way you could understand/show respect for what you had to say/spend enough time with you.” These items were summed into a provider communication satisfaction index, with higher scores representing greater satisfaction. The outcome variables included whether the respondent had seen a CAM provider such as an acupuncturist, faith healer, or person who works with roots/herbs, in the previous year. Covariates included education, income, medication insurance status, sex, and age. The final analytic sample after listwise deletion was 2,999. Results: Few JHS participants reported having sought CAM provider options: 0.53% (95% CI: 0.33, 0.87) of participants reported having seen a person who uses acupuncture, 0.50% (95% CI: 0.30, 0.83) of participants reported having seen a faith healer, and 0.60% (95% CI: 0.38, 0.95) of participants reported having seen a person who deals with roots or herbs in the previous year. The provider communication satisfaction index, sum of the four provider satisfaction measures, ranged from 4 to 16 (mean: 14.84, SD: 2.09, 95% CI: 14.77, 14.92). Participants who indicated higher levels of satisfaction with their healthcare providers’ communication had lower odds of having seen a person who works with roots or herbs in the previous year (OR: 0.83, 95% CI: 0.70, 0.99, p= 0.036). Associations between the provider communication index and use of other forms of CAM (i.e, faith healing, acupuncture) were not statistically significant. Conclusions: Overall, this study indicates that patient satisfaction with provider communication is associated with African American patients’ exploration of care from CAM providers, particularly those who work with roots and herbs.